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AIDS Drugs Boost Heart Attack Risk

Still, 'Cocktail' Therapy Provides More Benefit to Those With HIV

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"The substantial benefits of combination antiretroviral therapy continue clearly to outweigh the increased risk of myocardial infarction associated with this therapy," they write.

Agreed, say two experts who were not connected to the study but are thoroughly entrenched in research on how AIDS cocktails contribute to cardiovascular disease.

"The good news is that people with HIV are living longer, productive lives because of these drugs," says Judith Currier, MD, MSc, associate director of the UCLA Center for Clinical AIDS Research and Education, who has conducted her own studies on the association.

"Patients (getting these drugs) need to take measures, like everyone else, to lower their risk of chronic diseases -- and that includes atherosclerosis," she tells WebMD. "That means getting their lipids checked regularly, and looking at their diet, and exercise, and smoking habits in order to minimize their risk. Maybe they need to be more vigilant about it than other people, but definitely as least as much as others."

Currier calls this new study important and well done. "It contributes to our understanding and thinking about this subject. Since the more potent treatments have only been available for seven or eight years, we don't know yet about their long-term effect. But people are doing very well on these drugs, and our estimate is that this benefit will continue."

In her own research, she finds that HIV-positive patients who take protease inhibitors for at least two years have no increase in artery thickness compared with those not taking these drugs. This increased artery thickness could signal atherosclerosis, a marker for heart disease.

Some previous studies, like this new one, suggest there's a small but measurable increased risk of heart attack from newer, more potent drugs. But another major finding, published last February in TheNew England Journal of Medicine and involving some 37,000 treated with AIDS cocktails and other drugs since 1993, concludes that the "fear of accelerated vascular diseaseneed not compromise antiretroviral therapy over the short-term."

"If you look at a large enough group of patients carefully enough, there is a suggestion there may be a modest but significant increase in cardiovascular risk," says Daniel R. Kuritzkes, MD, director of AIDS research at Brigham and Women's Hospital in Boston, who wrote an editorial to the February study. "But there is an enormous benefit from antiretroviral therapy."

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